Do you have questions about foot injuries or the causes of foot pain? Tanglewood Foot Specialists provides the answers to frequently asked questions (FAQs) about foot injuries and foot care. If you would like to schedule an appointment to talk to a doctor about your foot pain, call Tanglewood Foot Specialists at (713) 785-7881.

IMPORTANT COVID-19 INFORMATION

Our office continues to be open to all new and existing patients. We use hospital-grade sanitizers and are taking measures to ensure patients maintain social distancing by not having anyone wait in our reception room with others. If you prefer to wait in your car, just give us a call and we will call or text you when we are ready to bring you straight into a treatment room. Our entire staff is wearing masks and we encourage you to do the same.

For those patients who cannot or still wish not to visit the office, we are offering private video telemedicine visits. Simply call the office at 713-785-7881 and ask for an e-visit and we will be happy to get you set up for an immediate appointment. You can also request an appointment through our website.

A custom orthotic device is recommended after many types of foot surgery, such as bunion or hammertoe surgery, to prevent the deformity from reforming. Because a neuroma does not return after surgery, since the nerve is unable to regenerate, some think that an orthotic is not needed after neuroma surgery. There is another good reason to utilize a custom orthotic after neuroma surgery.

In order to expose the neuroma during surgery, a ligament must be severed. Although the ligament heals, it does lead to an instability in the metatarsal arch and can cause the metatarsals to drop. A custom orthotic will support the metatarsal arch to prevent any problems occurring from this instability. If a custom orthotic was used prior to surgery, the same orthotic can be used afterwards.

Controlling the mechanics of your feet after foot surgery is a key to successful results. If you have had foot surgery and want to know if a custom orthotic will help you maintain a full recovery, contact Houston Podiatrist Dr. Andrew Schneider for a comprehensive evaluation.

While complications with neuroma surgery are uncommon, there are always possibilities with this and any foot surgery. The most common complication with neuroma surgery (and all surgeries) is a postoperative infection. In the foot, this usually occurs if the surgical dressings become soiled or wet. An infection presents with swelling and pain around the area thatwas operated on, often beyond what a pain medication will alleviate. It is crucial that you contact your Houston foot surgeon if you are concerned you have an infection after foot surgery.

Another common complication of neuroma surgery is a stump neuroma. This occurs when a neuroma forms on the end of the cut nerve. It is a very uncommon complication. This does not usually occur until substantial time has passed after the neuroma surgery and presents with a pain similar to that of the original neuroma. Treatment for a stump neuroma can include anti-inflammatory medication, cortisone injections, and also may require an additional surgery.

When some of your toes become numb, it can be because of a Morton's neuroma that has formed. This is commonly found in the second, third, and/or fourth toes. When a neuroma occurs between the metatarsal bones, pain often results in the ball of the foot. Because that nerve continues to the adjacent toes, it can also cause those toes to become numb.

When pressure on the neuroma is reduced, the numbness in the toes can be alleviated. This is accomplished with metatarsal support added to a custom orthotic device or applied directly to the foot. The support spreads the metatarsal bones and reduces the pressure on the nerve. This is also effective to alleviate the associated pain.

Foot pain is big business...just take a look at late night infomercials, the foot-care aisle in the pharmacy, SkyMall on an airplane, or the retail stores that prey on those suffering with foot pain. Not all insoles are created equal, however.

Two elements of an "off the shelf" insole is needed to reduce pressure on a Morton's neuroma. The first is control of hyperpronation. The "rolling in" that is caused by pronation causes compression of the metatarsal bones. I have found the best insole for this purpose to be Powerstep insoles which we carry in our office.

The other element needed for control of a Morton's neuroma is metatarsal arch support. This is hard to find on an OTC insole. In the office, we add metatarsal support to the Powerstep insoles dispensed for a neuroma. There are few insoles that come "off the shelf" with this support effectively added.

A quality insole should cost in the range of $30-$60, whether it is purchased in a shoe store, online, or a Houston podiatrist office. Unfortunately, there are those who charge in excess of $200 for a generic insole. If you are asked to pay this amount, or to invest in several different pair of non-custom insoles, you should beware.

The most common injection used to treat a Morton's neuroma is a corticosteroid injection. Cortisone, however, only treats the inflammation and not the neuroma itself. There are other injections that do address the actual neuroma.

A series of injections utilizing absolute alcohol is often effective to shrink the neuroma itself. This treatment is known as sclerosing injection therapy. The series usually lasts seven weeks, with one injection administered each week. While no treatment is effective for everyone, when these injections are successful they are able to prevent surgery. While a corticosteroid injection provides pain relief that is close to immediate, a sclerosing injection works differently. After the initial numbness of the anesthesia wears off, some people report an increase in the pain from the neuroma prior to experiencing pain relief.

A Morton's neuroma is a swelling of a nerve in the forefoot. The swelling is due to the pressure of the adjacent metatarsal bones on the nerve. This pressure also causes the nerve to become inflamed, which is primarily responsible for the associated pain.

Certain factors may contribute to the formation of the Morton's neuroma. Narrow shoes and shoes with a pointed toe box cause increased compression of the bones in the forefoot, thereby increasing the pressure on the nerve. High heels also can contribute to a neuroma, since they increase the pressure on the forefoot. For these reasons, a Morton's neuroma is more commonly found affecting women.

If you feel that you are beginning to suffer the early symptoms of a Morton's neuroma and feel pain in the ball of the foot, the first step you take should be to evaluate your shoes. Try to wear the widest shoes that still fit your feet. Very often, this change alone can remove pressure from the nerve and reduce or eliminate the pain.

Shockwave therapy is a newer treatment for different forms of inflammation. It is commonly used to treat resistant heel pain caused by plantar fasciitis or Achilles tendonitis. The two most common forms of shockwave therapy is Extracorporeal Shockwave Therapy (ESWT) and Extracorporeal Pulse Activated Therapy (EPAT).

Shockwave therapy can be used to treat pain from a Morton's neuroma, although it is not as commonly used as it is for heel pain and tendonitis. The therapy would serve to eliminate the inflammation of the neuroma which will control the pain. It does not, however, eliminate the neuroma itself. It is possible that the inflammation can return with time and a custom orthotic should be used to help to minimize the continued pressure on the nerve.

If you feel that you want to use a safe treatment with no need for medication, injections, or anesthesia, then EPAT is the right choice for you. Contact your podiatrist in Houston to schedule an appointment.

Nerves are unable to regenerate, which is why spinal cord injuries that lead to paralysis are permanent. Because of this, the portion of nerve that is removed in surgery for a Morton's neuroma does not heal together or regenerate. It is also why the surgery to remove a Morton's neuroma leads to some numbness in the toes.

It is possible that a neuroma can form on the end of the nerve that is cut during the surgery. This is an infrequent complication known as a stump neuroma, which can cause a return of neuroma-like pain. The pain is often able to be controlled with conservative measures, such as cortisone injections, but sometimes require an additional foot surgery to correct.

Neuroma surgery is one of the more straightforward foot surgeries there is. The neuroma is an inflamed swelling of the nerve. The surgery to correct a Morton's neuroma involves identification and removal of the swollen piece of nerve.

Because the enlarged portion of the nerve is removed, the pain associated with the neuroma is eliminated. In many cases the patient realizes this improvement soon after the surgery. After surgery, the patient is able to bear weight on the foot immediately, in most cases.

Don't let surgery scare you away. Like most surgeries it is a last resort. Neuroma surgery, when indicated and performed, is one that is very successful. Contact your Houston podiatrist to schedule an appointment to evaluate the pain in the ball of your foot and recommend the best treatment for you.

While anti-inflammatory medication, whether oral or a cortisone injection, is often helpful to reduce the pain of a Morton's neuroma, there are other treatments that are also effective. A series of sclerosing injections are useful in shrinking the neuroma, not only addressing the inflammation. These injections utilize dehydrated alcohol to accomplish this. While many patients do respond to this treatment, there are always some that do not.

Because the inflammation of a neuroma is caused by pressure on the nerve, relieving that pressure helps the inflammation to resolve. Incorporating metatarsal support into a custom orthotic device is the best way to achieve this. The metatarsal support allows the metatarsal bones to spread apart and reduce or eliminate the pressure on the nerve. In most cases, the orthotic will be used in combination with another treatment

Not all treatment options are right for everybody. Be sure to contact your podiatrist in Houston to schedule an appointment. The doctor will be able to provide you with the appropriate recommendation.